1-7. MILITARY INFORMATION & PAY WORKSHEET General Military Information
Service Number:
Present Rank:
Date Entered Service: Enlistment Date: Commission Date:
Regular/Reserve:
Flying Status:
Pay Date:
Promotion List Service Date:
Total Active Military Service Date:
Dates of Rank or Promotion
Dates of Active Duty Tours
Rank
Date
Rank
Date
From
To
From
To
Present Military Income
Deductions From Military Pay
Basic Monthly Pay..................................... $_______________ Basic Allowance for Housing (BAH). ....... $_______________ Basic Allowance for Subsistence (BAS). . $_______________ Family Separation Allowance (FSA)......... $_______________ Flight Pay. .................................................. $_______________ Foreign Language Proficiency Pay ........... $_______________ Hazardous Duty Pay .................................. $_______________ Hostile Fire Pay/Imminent Danger Pay.... $_______________ Medical/Dental Pay................................... $_______________ Sea Pay/Submarine Pay/Diving Pay. ....... $_______________ Other (Explain)........................................... $_______________ Other (Explain)........................................... $_______________
Federal Income Tax (FITW)....................... $_______________ Social Security Tax (FICA)......................... $_______________ State Income Tax For:. .............................. $_______________ Local Income Tax For: ............................... $_______________ Allotment To:.............................................. $_______________ Allotment To:.............................................. $_______________ Allotment To:.............................................. $_______________ Allotment To:.............................................. $_______________ Combined Federal Campaign................... $_______________ Other (Explain)........................................... $_______________ Other (Explain)........................................... $_______________ Other (Explain)........................................... $_______________
Total Military Pay and Allowances:....... $_ _____________
Total Deductions From Military Pay:.... $ _ _______________
Notes, Comments, Points to Check, Computations, etc.
CHAPTER 1 | MILITARY PAY & ALLOWANCES
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